Audit: MassHealth overpaid $1.3M to UMass Memorial

The results of a state audit released today found that MassHealth paid for $1.3 million in drug tests at UMass Memorial Medical Center that should not have been covered by the state-run program.

Auditor Suzanne M. Bump said MassHealth paid for a total of $9 million statewide in drug tests that were excessive or were not conducted for strictly medical reasons.

The $11 billion MassHealth program, which provides health insurance for low- and moderate-income residents, is supposed to pay only for drug tests that are ordered by physicians for medical reasons.

The audit said UMass Memorial conducted drug tests requested by sober homes for monitoring their residents. The hospital has agreed to return $1.3 million to the state for 23,882 drug tests it performed for residential monitoring.

UMass Memorial released a statement saying it is working with the auditor’s office to correct the errors. “When we determined after an internal review that orders from these independent labs may have been improperly submitted for payment, we immediately self-reported to the (auditor’s office) and MassHealth and initiated repayment for all such tests billed to government payers,” the hospital said. “We no longer work with any of those referring laboratories.”

Ms. Bump called on MassHealth to use stricter policies to manage payments for drug tests.